Thursday, April 23, 2009
A surgeon in Minnesota removes a sliver of tissue on a patient, thinking it was the appendix. It wasn't. The pathologist informed the operating surgeon that it was just a chunk of fat. So he brought her back to the hospital and removed what, by then, had become a perforated appendix. I hate when that happens.
I can understand how it could have occured. Advanced appendicitis can cause an intense inflammatory reaction, obscuring the normal anatomy. But you have to be extra-vigilant in these cases. Make a bigger incision if you need to. Be sure of the anatomy; follow the tenia coli of the cecum to their coalescence. For God's sake, open the specimen on the back table if you're uncertain. Ultimately, it seems that this particular patient recovered and resumed a normal life. But it just doesn't look good to have to treat appendicitis on the second try; we like elegance and precision when we operate....